Education push for state health benefit exchange

Saturday

Jul 27, 2013 at 12:01 AM

STOCKTON - John Hoang, a young attorney with the nonprofit Stockton Legal Center, wanted to know how his organization could better serve its poor clientele by helping them obtain affordable health insurance when it becomes available to millions of Californians starting Jan. 1.

Joe Goldeen

STOCKTON - John Hoang, a young attorney with the nonprofit Stockton Legal Center, wanted to know how his organization could better serve its poor clientele by helping them obtain affordable health insurance when it becomes available to millions of Californians starting Jan. 1.

"We're hoping this is our best opportunity to get them in Medi-Cal," Hoang said after hearing a presentation about Covered California, the state's new health benefit exchange established through 2010's federal Patient Protection and Affordable Care Act.

He said it was his first attempt to learn about the massive outreach and education efforts being planned by Covered California to inform residents about the exchange. Those who will benefit the most are often disenfranchised individuals who face language, transportation, financial and cultural barriers to services.

The California exchange was the first state exchange to get started in no small part because the need is greater here than anywhere else in the country. State officials estimate that about 2.6 million residents will qualify for federal financial assistance, or subsidies, while an additional 2.7 million who do not qualify for assistance will benefit from guaranteed insurance coverage.

Covered California brought its roadshow to Stockton for the first time in the form of a town hall meeting at the urging of two of the area's state legislators, Assemblywoman Susan Talamantes Eggman, D-Stockton, and Sen. Cathleen Galgiani, D-Stockton.

About 300 people attended the meeting to hear Dana Howard, a former Sacramento-based television newsman who is the new face of Covered California as its deputy director for media relations, explain the key elements of the exchange and how quickly it is ramping up for its Oct. 1 launch.

That's the date that open enrollment begins through the exchange for people younger than 65 who are legal residents of California and do not have access to affordable health insurance through an employer or a government program.

Eggman, in addressing the audience, which included representatives from a number of nonprofit groups, social service agencies and health-related organizations interested in providing outreach, reminded them of "the huge disparities in our Valley. California has taken the lead on this, and we need to show in California that this can work. We need to enroll as many people as we can," she said.

Covered California is training about 2,000 certified enrollment counselors, formerly known as assisters, to get people enrolled in coverage during the six-month open enrollment period from Oct. 1 through March 31. As new state employees dealing with sensitive, personal information, they will be fingerprinted and have to clear background checks before going to work.

Howard said the goal is to have a "smooth enrollment" in a "language and with the cultural sensitivity that you understand." It is a crucial step in getting the public to trust the exchange.

He reminded his audience of the standard elements the Affordable Care Act offers. One of those is Essential Health Benefits, which all insurance plans must offer. Those include services such as doctor visits, hospitalization, emergency care, maternity care, pediatrics, prescriptions, medical tests and mental health care.

All plans must cover preventive services, such as mammograms and colonoscopies, with no out-of-pocket costs to the insured. And pre-existing conditions, such as heart disease, cancer or diabetes, are no longer barriers to obtaining coverage.

Consumers who are currently purchasing individual insurance on the open market will quickly see savings through the exchange for comparable coverage, Howard said.

In San Joaquin County, individuals and small businesses will have access to four private insurers through the exchange - Anthem Blue Cross, Blue Shield, Health Net and Kaiser. Typically, Howard said, small businesses are not able to offer their employees choices, but after Oct. 1, that will all change.

Information on Covered California is available on its website at coveredca.com.